Annals of Family Medicine
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH SEARCH RESULT
QUICK SEARCH:   [advanced]


     

Annals of Family Medicine 8:64-72 (2010)
© 2010 Annals of Family Medicine, Inc.
doi: 10.1370/afm.1073
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow In Brief
Right arrow TRACK Discussion: Submit a Comment
Right arrow TRACK Discussion: View Comments
Right arrow Alert me when this article is cited
Right arrow Alert me when TRACK Comments are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Perera, C. L.
Right arrow Articles by Maddern, G. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Perera, C. L.
Right arrow Articles by Maddern, G. J.
Related Collections
Right arrow Quantitative methods

Safety and Efficacy of Nontherapeutic Male Circumcision: A Systematic Review

Caryn L. Perera, BA, Grad Cert EBP1, Franklin H. G. Bridgewater, MBBS, FRACS2, Prema Thavaneswaran, BSc (Hons), PhD1 and Guy J. Maddern, PhD, FRACS1,2,3

1 ASERNIP-S, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
2 Department of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
3 Department of Surgery, The University of Adelaide, Adelaide, South Australia, Australia

CORRESPONDING AUTHOR: Guy J. Maddern, PhD, FRACS, ASERNIP-S, First Floor, 38 Payneham Rd, Stepney SA 5069, Australia, guy.maddern{at}adelaide.edu.au

PURPOSE We wanted to assess the safety and efficacy of nontherapeutic male circumcision through a systematic review of the literature.

METHODS We systematically searched The York Centre for Reviews and Disseminations, Cochrane Library, PubMed, and EMBASE databases for randomized controlled trials published between January 1997 and August 2008. Studies reporting on circumcision in an operative setting in males of any age with no contraindications to or medical indications for circumcision were eligible for inclusion. The main comparator was intact genitalia. From 73 retrieved studies, 8 randomized controlled trials were ultimately included for analysis.

RESULTS Severe complications were uncommon. Analgesia/anesthesia during circumcision was promoted. The prevalence of self-reported genital ulcers was significantly lower in circumcised men than uncircumcised men (3.1% vs 5.8%; prevalence risk ratio 0.53; 95% confidence interval [CI], 0.43–0.64; P<.001). Circumcised sub-Saharan African men were at significantly lower risk of acquiring human immunodeficiency virus/acquired immune deficiency syndrome than were uncircumcised men (random effects odds ratio = 0.44, 95% CI, 0.32–0.59; P <.001). The evidence suggests that adult circumcision does not affect sexual satisfaction and function.

CONCLUSIONS Strong evidence suggests circumcision can prevent human immunodeficiency virus/acquired immune deficiency syndrome acquisition in sub-Saharan African men. These findings remain uncertain in men residing in other countries. The role of adult nontherapeutic male circumcision in preventing sexually transmitted infections, urinary tract infections, and penile cancer remains unclear. Current evidence fails to recommend widespread neonatal circumcision for these purposes.

Key Words: Circumcision, male • sexually transmitted diseases • HIV • acquired immunodeficiency syndrome • penile cancer • urinary tract infections • prophylactic procedures




This article has been cited by other articles:


Home page
 Ann Fam MedHome page
Corrections
Ann. Fam. Med, March 1, 2010; 8(2): 185 - 185.
[Full Text] [PDF]

Home page
 Ann Fam MedHome page
J. J. Frey III
In this issue:race, place, and sex matter.
Ann. Fam. Med, January 1, 2010; 8(1): 2 - 3.
[Full Text] [PDF]

TRACK Comments:

Read all TRACK Comments

Safety and Efficacy of Nontherapeutic Male Circumcision: A Systematic Review
Rich Finegan
Annals of Family Medicine, 17 Jan 2010 [Full text]
Too narrow to promote preventative medicine (circumcision)
Michael J Bates
Annals of Family Medicine, 14 Jan 2010 [Full text]
Poor quality article omits randomized controlled trial of UTIs, as well as RCTs of STIs, and appears biased
Proffessor B Morris
Annals of Family Medicine, 15 Jan 2010 [Full text]
Previous Cochrane review on topic not cited
Nandi L Siegfried
Annals of Family Medicine, 15 Jan 2010 [Full text]
In a word, there are no indications.
George C Denniston, MD MPH
Annals of Family Medicine, 15 Jan 2010 [Full text]
Not All RCTs are Created Equal
Robert S. Van Howe
Annals of Family Medicine, 20 Jan 2010 [Full text]
Details on Quoted Studies
Anthony P Catinella
Annals of Family Medicine, 20 Jan 2010 [Full text]
Rebuttal to Commentary Claims on (STDs/STDIs)/UTIs
Tom M. Riddle
Annals of Family Medicine, 22 Jan 2010 [Full text]
Limitations of RCTs when Examining Male Circumcision
Erin J Starzyk, MPH
Annals of Family Medicine, 28 Jan 2010 [Full text]

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH SEARCH RESULT
Copyright © 2010 by the Annals of Family Medicine.